Just For Canadian Doctors Summer 2016

summer 2016

DOCTORS life + leisure

scandinavian

In t o th e f jord!

summer in Norway

sail AWAY God’s Island Ontario to

in

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$1,o00 towards

any CME COURSE page 12 $50

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DOCTORS life + leisure

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summer 2016

contents

summer 2016

Publisher Linh T. Huynh

Editor Barb Sligl

Art Direction BSS Creative Contributing Editor Janet Gyenes

Editorial Assistant Adam Flint Contributors Lucas Aykroyd Michael DeFreitas Janet Gyenes Sharon Matthews-Stevens Dr. Chris Pengilly Manfred Purtzki Dr. Kellen Silverthorn Barb Sligl Roberta Staley Mark Stevens

Cover photo Barb Sligl

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Senior Account Executive Monique Nguyen

Account Executive Wing-Yee Kwong Production Manager Ninh Hoang

Circulation Fulfillment Shereen Hoang

CE Development Adam Flint

Sales, Classifieds and Advertising In Print

Circulation Office 200 – 896 Cambie Street Vancouver, BC V6B 2P6 Canada Phone: 604-681-1811 Fax: 604-681-0456 Email: info@AdvertisingInPrint.com

FEATURES

16 Nordic cool It’s a sweet Scandinavian summer in Norway 29 God’s Island Sail Ontario’s southwestern lake country COLUMNS

DEPARTMENTS

8 photo prescription

5 Summer mix 23 CME calendar 37 sudoku 38 small talk

Capturing the Big Island’s contrasts

clockwise from top left: barb sligl; sharon matthews-stevens; barb sligl

Just For Canadian Doctors is published 4 times a year by Jamieson-Quinn Holdings Ltd. dba In Print Publications and distributed to Canadian physicians. Publication of advertisements and any opinions expressed do not constitute endorsement or assumption of liability for any claims made.

The contents of this magazine are protected by copyright. None of the contents of the magazine may be reproduced without the written permission of In Print Publications.

In Print Publications 200 – 896 Cambie Street Vancouver, BC V6B 2P6 Canada

11 pay it forward Medicine under fire

12 motoring

Doctors’ summer reading list

The devil is in the detail(ing)

14 the thirsty doctor

Bitter booze is all the rage

35 doctor on a soapbox

Keeping to time

36 the wealthy doctor

www.justforcanadiandoctors.com

Wealth creation tips for new MDs

Printed in Canada.

want to reach us? check out our website!

cover photo

Into the fjord…arriving at Hotel Union Øye via Hjørundfjord on the west coast of Norway. Think Valhalla (page 16).

Summer 2016 Just For Canadian doctors

3

from the editor Sailing in Ontario’s lake country, trailing the Group of Seven…and bears. Story on page 29.

into the wild they all speak English flawlessly. It’s time to experience this Nordic cool.

Another cool spot this side of the Atlantic, with a laid-back west-coast vibe of its own, is discover Seattle. Yes, there’s coffee, the fish market and coastal beauty but also some thought-provoking art and architecture (page 23).

Perhaps the most wild place coming up will be Brazil, where it’ll really heat up with the 2016 Summer Olympic Games. Rio de Janeiro promises to put on a spectacular party. But go beyond

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Just For Canadian doctors Summer 2016

sharon matthews-stevens

B

arefoot and bound for adventure. It’s the carefree feeling that comes with spring and only gets stronger into summer, when the warmth and long days bring on an appetite for exploration.

Let loose on deck aboard a vessel in Ontario’s lake country, where you can sail to the divine-sounding God’s Island. This is where the Group of Seven once found inspiration, and these shores still seem untouched. So much so that you may encounter a bear swimming across your sailboat’s path, like the author of our “at home” feature story did (page 29).

Also wild and wonderful is Norway (page 16), where Scandinavian style is everywhere. Not only does this country have stunning scenery, design savvy and out-ofthis-world seafood, but the people are some of the loveliest you’ll meet—and, of course,

its hopping seaside spectacle and deep into the Amazonian jungle to cavort with caimans and macaws (page 5).

On the Pacific side is another wild spot that’s churning quite literally. The Big Island of Hawaii might not be the first place you think of for a late-spring or summer getaway but you’ll find snow (if you’re looking for that come June) and surf and sand and lava—all in one diverse isle of contrasts. And that means it’s the ideal place to practise your photography skills (page 8).

Of course, just because things are heating up and getting wild doesn’t mean work stops (unfortunately). But you can combine work and pleasure by planning your CME meetings in some of the wild places we visit throughout this issue. To help you do just that, we’ve created an online database that highlights the latest conferences and continuing medical education opportunities around the world (justforcanadiandoctors.com/cme/).

Another bonus: register for a subscription to email notifications for CME courses, and you could win $1,000 to the course of your choice (see the promo on page 12). Good luck and happy (and wild!) travels.

Any ideas, comments or questions? Reach us at feedback@InPrintPublications.com.

what/when/where > summer

style | food | drink | festivals | places | getaways | gear‌

mix

preOlympics

tour

jungle fever

Using a blowgun in the rainforest. right Sunrise over the Pantanal.

Dusk in the Brazilian wetlands. right Caimans abound in Amazon rivers.

deep into brazil Andre Maceira/Brazil Tourism

From the Amazon to the Pantanal, South America’s biggest country burgeons with natural wonders

Riding Pantaneiro horses. left

Hyacinth macaws perch overhead.

Summer 2016 Just For Canadian doctors

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mix

bon-bon

summer

go natural in brazil

into the jungle

rumped caciques chirp in glorious cacophony on a nearby island.

The numbers that define the Pantanal’s biodiversity are similarly staggering—and it’s often easier to view creatures here as they’re more out in the open.

Covering upwards of 150,000 square kilometres, this region in central-western Brazil is home to some 700 bird species, 250 fish species, 100 mammal species, and 80 reptile species.

Driving the dusty Tranpantaneira road to the Araras Pantanal Eco Lodge, sightings of capybaras— the world’s largest rodent—and crab-eating foxes are plentiful. Upon arrival, enjoy grilled pacu fish and

Parisian

Double rainbow over Juma Lake.

Pantanal—the world’s largest tropical wetlands— will endure long beyond any sporting event.

Founded in 1669, jungle-ringed Manaus is famed for its domed opera house, financed by the 19thcentury rubber plantation boom. You’ll feel your heart singing as you take a boat tour of the Rio Negro, an Amazon tributary, en route to the Juma Amazon lodge with comfortable bungalows on stilts.

When you pause to explore the forest, your guide, whose painted cheeks depict canoe legends, wields his machete. He chops open a biriba fruit, sweet and goopy.

He shows how Aztec ants come swarming out when he yells at their brown, misshapen nest, and then rubs them into his skin to create a natural scent camouflage—similar to cheese—against predators. Later, you’ll use a blowgun with darts, catch and hold a baby caiman, and marvel at the antics of capuchin monkeys.

You could even experience the surreal, raw power of witnessing a double rainbow on Juma Lake, moments after a thunderstorm. Pink river dolphins surface around the boat, and close to 5,000 yellow-

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lamb stew for dinner, surrounded by glowing yellow lanterns and jaguar and armadillo carvings.

This is an ornithologist’s paradise. During group rides on Pantaneiro horses, hyacinth macaws perch in nearby tarumã trees, casting curious glances, and snail kites soar overhead.

Throughout the day, the Pantanal’s sights and sounds are powerfully absorbed from a 25-metrehigh viewing tower erected in the forest. At dusk, a ferruginous pygmy owl makes a shy cameo. At sunrise, howler monkeys raucously defend their territory.

“Morning is magic,” says the guide. “All the animals are waking up and thanking God for another day with nature.” You’ll feel overwhelming gratitude too as you soak up Brazil’s natural thrills.

— Lucas Aykroyd if you go For more info, go to the websites of Brazil Tourism at visitbrasil.com, Juma Amazon Lodge at jumalodge.com and Araras Pantanal Eco Lodge at araraslodge.com.br.

Just For Canadian doctors Summer 2016

pâtisserie paris in vancouver

taste

Visit a Parisian tea salon…in Vancouver. Ladurée, historic purveyor of ooh-la-la macarons in the City of Light, has opened up its first outpost in Canada. The Ladurée Vancouver Boutique and Tea Salon has a façade that evokes the historic Rue Royale boutique in Paris (the original pâtisserie dates back to 1862 when Louis Ernest Ladurée opened the bakery on 16 Rue Royale), and inside are trompe l’oeil skies with angels and goldand-marble counters displaying pastel-coloured macarons, viennoiseries, teas, jams and a collection of perfumed candles and home fragrances.

And, to celebrate this Canadian opening, there’s a special maple syrup macaron. The macarons are also available in limited-edition gift boxes (above), by fashion illustrator Kerri Hess (who’s also worked with the likes of Chanel, Louis Vuitton, Lancôme Paris). Ooh-la-la, indeed! laduree.com

Andre Maceira/Brazil Tourism; courtesy Ladurée

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our guide kneels, poking a long palm frond into a hole to coax a female tarantula to come out. Hairy legs appear ominously at the entrance. Since you’ve just heard these massive spiders can throw barbed hairs in self-defence, you back up as your spine tingles in anticipation. (Fortunately, she’s a nice tarantula.)

It’s one of many electrifying get- moments on a nature-themed visit away to Brazil, the world’s fifth-largest country. The Rio Olympics may dominate current tourism headlines, but the beauty and strangeness of both the Amazon and the

personal statements

summer

mix

Companion pieces Make your mark with these iconic items Written + produced by Janet Gyenes

signature style

top talisman

What’s your stylish symbol? Initials, a lucky number or secret code? Put your personal stamp on an engravable talisman pendant from Vancouver’s Pyrrha. Born from heraldic icons, these talismans come in seven styles (available in sterling silver and bronze) such as Eagle, a symbol of integrity and strength, and adorn Unity; the ribbon represents an -ment unbreakable bond when engraved with two initials. Or make a statement with Harmony cufflinks from Pyrrha’s new 18-karat gold collection. The lions serve as a reminder to keep an even mind and overall balance. Eagle pendant, $259; Unity pendant, $183; Harmony cufflinks, $2,880; pyrrha.com homage to an icon

Metallic polish

City sojourn Shouldn’t your mode of transporation be about play, even when commuting to work? This sleek city bike by Martone Cycling Co. covers the bases with a built-in basket (optional on mens’ models), cheery red gear chain (the brand’s signature) and double-walled aluminum frame that’s light and durable.

Women’s bike in Greenwich (other styles and colours available), $1,750; The Room at Hudson’s Bay, martonecycling.ca

The world gasped when the bright light that was Davie Bowie (aka Starman) was snuffed out too soon. As part of its new travel collection and an homage to the icon, Edmonton-based Poppy Barley has fashioned a range of footwear in Stardust Silver leather, like the style Zipper Bootie. These kicks feature a 2.5-inch stacked heel and rubber sole to keep you on firm footing.

All Poppy Barley footwear is handcrafted in Mexico and the brand offers a collection of made-tomeasure boots for muscular calves or narrow feet. Zipper Bootie, $350–$375; poppybarley.com

Lucite comfort pedals

ridE

ON

p h o t o p r e s c r i p t i o n m i c h a e l d e f r e i ta s Michael DeFreitas is an award-winning photographer who’s been published in a wide variety of travel publications. With his initials, MD, he’s been nicknamed “doc,” making his photography prescriptions apropos.

a study in contrasts

Hawaii’s Big Island appeal is its grand sense of contrast and unpredictability

Send photos and questions to our photography guru at feedback@ inprintpublications.com and your shot may be featured in a future issue!

destination photography

Apply your photography skills to the shooting situations of the BIG ISLAND of Hawaii.

grey is okay

Just north of Hilo are two of the island’s most famous waterfalls, the 80foot Rainbow Falls and 200-foot tiered Umauma Falls. Here, I’m happy for a slightly overcast day so that I can utilize slow shutter speeds (1/10 and 1 second) to make the water look wispy. By using my medium zoom lens (at 50mm–70mm) and f20 for a wide depth of field, I’m also able to include some foreground elements.

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Just For Canadian doctors Summer 2016

if you go

For info on the Big Island: gohawaii. com/en/ big-island/

michael defreitas

T

he drive up Mauna Kea’s steep and curvy summit dirt road is as challenging as it is breathtaking.

Besides having no guardrails, the biggest trial for most drivers is keeping their eyes on the road and off the spectacular vistas that pop up around every corner.

At the snowcapped summit, I set up my tripod and wait for the spectacular sunset. I use my wide-angle zoom lens (set at 14mm) to include a nearby snow-covered cinder cone for a sense of place and the surprise of snow in a tropical destination. As the sun drops below the cloud cover its orange glow lights up the snow-covered scene and I fire off a few frames at f16 and 1/125 second. It’s not until I edit my photos back home that I notice the snowboard tracks crisscrossing the slope of the cinder cone. Snowboard tracks in Hawaii—unpredictable or what?

The Big Island, Hawaii, differs from its siblings in its stark contrasts. The laidback Hilo or east side of the island offers an authentic Hawaiian culture amid a lush tropical backdrop, while the Kona or west side is arid, busy and touristy. Both sides provide a wealth of photographic opportunities.

Despite being the island’s largest city, Hilo has maintained the ambience and culture of a small, old-fashioned Hawaiian town.

My first stop is the city’s festive Farmers Market that offers everything from local batik sarongs to pots of orchids and stacks of ripe fruit and vegetables. I find a pile of mangoes perfectly lit by the early morning light and position my wide-angle zoom (set at 14mm) close to the fruit. Including people in the background helps to establish a sense of place, but it’s important that the people not be the centre of attention in every shot.

By using f8 and focusing on the mangoes about a half-metre in front of the camera, I’m able to accentuate the lush fruit and render the background shoppers slightly out of focus (to make sure the mangoes are what draws the eye). By using 1/125 second, I freeze the human motion.

My next stop is literally and figuratively the island’s hottest spot. Just 70 kilometres south of Hilo, the Kilauea volcano (Hawaiian for “much spreading”) has erupted continuously since 1983. Situated in Hawaii

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action shot

Volcanoes National Park, it’s one of the most active volcanoes on earth. Although today’s eruption doesn’t feature the 100-metre-high lava fountains, dense plumes of smoke and ash of past eruptions, it’s still a not-to-bemissed event.

You can view the molten lava flowing into the sea from Hakuma Point on the east side of the flow, or from the west side at Kamoamoa along the park’s Chain Of Craters Road. But, despite my fear of heli-

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copters, I opt for an aerial perspective. Aerial tours depart Hilo airport daily and some operators offer fully sensory “doors-off” tours.

From above, the juxtaposition of lush-green vegetation and the bright-red rivers of molten lava cutting through blackened lava fields offers yet another striking contrast.

I use a medium zoom range lens (60–70mm) to frame the lava rivers and a high shutter speed (1/800– 1/1000 second) to eliminate engine vibrations.

Framing the lava flows diagonally creates leading lines and allows me to place contrasting green and black patches in opposite corners of the frame.

Armed with lots of land-based signature images, I shift my attention to the Hawaii’s

Just For Canadian doctors Summer 2016

great surfing. The two most important factors for getting great surfing shots are vantage point and sun angle. Although early morning or late day sun offers a lovely warm glow, its lower angle produces more glare and tends to render the water dark. Late morning light (10am to noon) penetrates deeper into the water accentuating its blue colour while providing a bit of reflected light to help illuminate the surfers.

I pick a top surfing spot on the west coast to utilize a bit of frontal lighting from the higher morning sun. Before shooting, it’s always best to watch the action for a while to determine the best-lit angle and composition (remember that diagonal compositions help accentuate action). After finding a couple of advanced surfers practising tricks, I set up my tripod and use a 300mm zoom lens to snap a variety of shots using 1/250–1/800 second and f11–f16. With my motor drive set on high speed I compose with the surfers entering the frame, not leaving it.

With so many unpredictable photo opps—from sputtering volcanoes to churning surf—make sure that you and your camera are always ready on the Big Island. Aloha!

michael defreitas

photo prescription [continued]

pay i t f o r w a r d

r o b e r ta s ta l e y

Roberta Staley is an award-winning magazine writer and the editor of the Canadian Chemical News, published by the Chemical Institute of Canada. She is also a magazine writing instructor at Douglas College and a graduate student at Simon Fraser University.

medicine under fire

Despite dire threats and emotional toll, this doctor feels repaid working abroad for MSF

courtesy of Dr. bruce lampard

T

he boy, Osman, arrived by ambulance to the Médecins Sans Frontières (MSF) Ebola treatment centre in eastern Sierra Leone. It was November 2014—nine months after the Ebola outbreak began— and the virus was in full bore across West Africa. Dr. Bruce Lampard, an emergency physician at Toronto General and Toronto Western hospitals and a veteran of MSF missions, recalls Osman and another patient disembarking from the ambulance, “both walking and talking.” Over the next few days the two became sicker: muscle pain, headache, diarrhea and vomiting, kidney failure, bleeding gums and internal bleeding.

Both fell unconscious. The man eventually succumbed; Osman’s death appeared imminent. Lampard and MSF staff kept him on morphine but withdrew intravenous fluids.

“It looked as though his kidneys were shutting down; we were expecting him to die at any hour. There’s nothing you can do at that point,” Lampard says.

Several days later, however, as he began early morning rounds, Lampard was startled to see Osman, propped up on one elbow in bed. “I’m hungry,” he told dumbfounded staff. “It was uplifting; it gave us hope,” says Lampard. As to why the boy survived, Lampard shrugs. “If the immune system is able to figure out a way to deal with the virus fast enough, then you’ll survive. If it can’t, then you don’t.”

Survival wasn’t the usual fate for many of those stricken with Ebola in the West African nations of Guinea, Liberia and Sierra Leone. More than 11,000 people died out of at least 28,000 confirmed and/or suspected Ebola cases, according to the World Health Organization. It wasn’t just the lack of a cure that Lampard and other MSF workers had to deal with. Global apathy was the other scourge. For much of 2014, as MSF set up medical facilities in the stricken nations, the world simply watched. “We kept yelling and yelling and saying hey, ‘we can’t do this, we need help.’” It wasn’t until Ebola was seen as a global health security threat, with cases diagnosed in Europe and Texas, that the West became involved, says Lampard, a lecturer at the University of Toronto Department of Medicine.

Lampard first joined MSF after completing his residency following graduation from the University of Calgary’s medical school. As a young physician, he committed his first five years of practice to MSF, treating patients in South Sudan, Nigeria, Afghanistan, Burundi, the Democratic Republic of Congo, Chad, Central African Republic and Somalia—places with “poorly or no functioning health care system.” Here, the need and the work were often “overwhelming— exhausting physically and mentally.”

Lampard has also undertaken executive functions as well as fieldwork with MSF, serving as the Canadian office’s president, vice-president and chairman of the board, setting strategic direction and representing the country within the global MSF movement.

Currently, one of the key challenges that MSF is facing is increasing attacks by military groups on its medical facilities, resulting in the deaths of staff and patients. This past April, Al Quds hospital, an MSF and Red Cross facility in Aleppo, Syria, was destroyed in an airstrike, resulting in the deaths of two physicians and a dozen staff and patients. (It is suspected that the regime of Syrian President Bashar Hafez al-Assad was behind the attack.) Less than a year ago, a United States Air Force gunship bombed MSF’s Kunduz Trauma Centre in northern Afghanistan, killing more than 40 staff and patients and injuring at least 30 more. Attacks have also been carried out on facilities in South Sudan, Ukraine, Yemen and Central African Republic.

Ever since it was formed in 1971, MSF workers have been attacked, killed and kidnapped. But such occurrences have been infrequent, with few victims, and mostly

carried out by rebel groups and gangs. The past five years has seen attacks by organized military forces using smart weapons— laser-guided bombs and projectiles—thus breaking the standards of humanitarian international law as established under Geneva Conventions. “The Dr. Bruce irony is that now Lampard does we are seeing atfieldwork for MSF, and has also served as the Canadian office’s president.

tacks by nations sitting on the United Nations Security Council, a body mandated to uphold international peace and security,” Lampard says.

This has forced MSF to set up its medical facilities, rather than on the front lines, on the periphery of battle-torn areas, in refugee camps or even adjacent countries. “We would love to be massively scaling up our programming but just can’t do it,” Lampard says.

The threats can be dire, the work conditions extreme and the emotional toll draining. Yet, for Lampard, working for MSF has repaid itself many times over, as he thinks back to the inspiring resilience and humility of his patients. The missions abroad have meant that Lampard has spent considerable time away from family, working in dangerous and unstable areas. But it has “been so incredibly meaningful for me that the sacrifice was worth it. I’d do it all again—absolutely— in a heartbeat.”

Summer 2016 Just For Canadian doctors

11

motoring

D r . k e l l e n s i lv e r t h o r n Dr. Kellen Silverthorn is Just For Canadian Doctors’ automotive writer. He tries to keep one convertible and/or one track-day car in the family fleet.

the devil is in the detail(ing) The paradigm-shifting hybrid car keeps getting greener + better

A

colleague, while finalizing an expensive car purchase, asked me if he should opt for the $995 paint and interior protection package. To underscore my position we Googled Consumer Reports.

As I expected, the basic advice was to avoid such a package as “vastly overpriced.” My friend was only partially satisfied; “So, if not the dealer-applied versions, then how should I protect my investment?”

Which begs the question—from what, exactly, are we protecting our cars? An abridged list: ultraviolet rays, big-city smog, impaled insect entrails, salt, hail, sand, brake and other dust, door dings, (take a breath), tar, gas spills, acid rain, flying rocks, flying ferrous flakes, air-borne-tree-goo, and divebombed-bird-pooh.

Paris

Meanwhile, that same car’s interior is exposed to a diluted version of the above list—plus, we grind the carpet with our feet, and abrade the upholstery with our bums.

Also: pens, lipstick and other crayons, cigarette and other smoke, newspaper ink stains, fingernail/jewelry scratches, desiccated human skin, dog hair and drool, and every type of foodstuff and beverage. Again, intermittently applied interior products beats replacing even one interior surface.

So “protecting our automotive investment” is really all about a regular program of cleaning-then-protecting. And whether you realize it or not, those in the trade can easily discern the proposed trade-ins that have been well protected since birth. You can guess which car the trade covets. The result-

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ing valuation spread between two otherwise identical cars can be 25% or more.

Hopefully, I’ve convinced you that the sizable investment parked on your driveway is worth protecting. The next big follow-on question, then, is exactly who is going to clean and protect your car?

Your key candidates are: well, there’s you of course, or, a family member or neighbour who is willing/coerced/paid/ quid pro quo’ed—or a professional “detail” shop. A quality detail shop’s services would be the money-no-object solution for all of your car’s cleaning and protection needs. However, that service may cost you $50–$100 per hour several times a month.

Almost as costly as a teenager’s cell account.

I do take my beloved vehicles for profes-

Where do you wanna be for your next CME?

For inspiration on where to go, search our current CME course database by specialty, location or date at justforcanadiandoctors.com/cme.

Hong Kong

Japan

Greece

Hawaii

WIN $1,000*

TOWARDS YOUR CHOICE OF ANY CME COURSE. go to justforcanadiandoctors.com/subscribe

*Chance of winning is dependent on number of registrations. Only one (1) $1,000 prize will be awarded for use towards a future CME course and is not redeemable for cash. Registration information becomes the property of Just For Canadian Doctors, published by Jamieson-Quinn Holdings Ltd. and will not be shared with any third party. To be eligible for draw, registrant must be a Canadian practising physician and registration is received by midnight June 30th, 2016.

12

Just For Canadian doctors Summer 2016

kellen silverthorn

motoring [continued]

sional detailing to my local experts Julian Richards and his crew to help protect my automotive investments. Originally a journeyman Ferrari mechanic in the UK, Julian shifted to the detailing side of the trade long before moving to Canada 13 years ago. His Right Touch Auto Detailing has a staff of six with 75+ years of collective detailing experience (some of the crew, above).

Julian has sagely steered me toward various equipment, products and techniques through the years. And when I explained to Julian my desire to educate our Just for Canadian Doctors readership on detailing, before you could say “wet polish,” I’d been added to his shop’s team as intern for a week of afternoon shifts.

Here’s what I learned. Divide detailing into wet and dry phases.

There are two levels of wet phase detail (minor and major). In the “minor version”

the equipment needed is a water hose, bucket-withbottom-grate filled with warm soapy water and microfibre mitt and chamois. The steps are pre-rinse, wash, rinse, then chamois. Pretty simple, and more-or-less what dad taught us.

The major exterior wet-clean adds four steps after “pre-rinse” for which you need degreaser spray, wetted blocking sponge and wetted clay bar. If the tree sap or bird pooh are not responding to these, then apply spot methyl hydrate soaks. Patience is key here, not aggressive rubbing! I also clean inside the door/trunk jams and fuel-filler door in a major wet clean, as well as using a specific wheel cleaner fluid and brush.

My “dry” detail phase also has both a minor and a major version. The minor version is a quick interior vacuum and dressing tires. The major version of the dry phase includes using a $189 Canadian Tire six-inch

random orbital polisher with micro-fibre head. With this tool I apply the Auto Glym Super Polish. If scratches in the factory clearcoat paint layer are still visible after the wax/ polish step, then refer to a pro like Julian. My major dry phase clean also includes carpet shampoo, followed by vacuuming. Similarly upholstery/leather/vinyl is product-specific cleaned, then protected. Glass polish and door rubber silicon treatments are optional.

Odours that don’t disappear with a major dry clean can be considered for “fans and Febreeze,” or else referred to the pros.

I can perform my minor wet/dry combined home detailing in 30 minutes. My major wet/dry steps take 90 minutes per car.

I’ll usually do “the wife’s ride” in the same session—in the vain hope of some later quid pro quo.

I recently bumped into my colleague with the new expensive car. He had said “no” to the dealer-applied protection package. He’ll never be more motivated than today to protect his automotive investment.

So he’s going to come by my house and check out my detailing gear and techniques.

See-one, do-one, teach-one déjà vu.

Summer 2016 Just For Canadian doctors

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the thirsty doctor janet gyenes Janet Gyenes is a magazine writer and editor who likes to dally in spirits, especially when discovering something like corenwyn jenever (a gin-like Dutch spirit)—straight or in cocktails like the “bramble.” Have a boozy idea or question? Send it to feedback@inprintpublications.com

bitter crush

Herbal liqueurs or Italian amari have seduced the cocktail crowd

D

esperate times call for desperate measures. The proverb is apropos of how Fabio Martini and Joel Myers of The Woods Spirit Co. came to distill amaro, their first-ever spirit. Amaro is the Italian word for “bitter” and it describes an herbal liqueur made in the land of dolce vita.

The story isn’t exactly a tale of love and war, but close enough. The love interest: the Negroni cocktail. The war: BC’s Campari shortage last year. The hand-wringing was real and the news media ran half a dozen or more stories about bartenders lamenting the loss of this powerful bitter liqueur in their arsenal.

Martini says he and Myers decided to distill a replacement for the Italian amaro—with a West Coast twist. As fanciful as this bitter orange crush might sound, the pair came by distilling honestly. “We’re foragers,” Martini explains. He had run a small foraging tour company and one day, when hiking with Myers, the idea for starting a craft distillery came ‘out of the woods,’ he says. “We started out wanting to make a gin from the forest.” Instead, the Campari shortage spurred them to make “a modern liqueur with a deep respect for the Italian tradition of amaro.”

The roots of bitter liqueurs wander far beyond the boot. According to Jim Meehan’s tome, The PDT Cocktail Book, the first bitter liqueurs distilled from herbal ingredients such as bark, herbs and spices were “made by medieval monks or apothecaries as elixirs and health tonics in Northern Europe, France, Italy and Spain.”

In fact, the “desperate times” proverb has Latin origins that translate to “Desperate diseases must have desperate remedies.”

It makes sense: the main bitter ingredient in herbal liqueurs is gentian root, which was used to battle ills such as malaria and parasites.

Today most bitter liqueurs are made in Italy, following time-honoured recipes that are virtually classified. Some are aperitivos, sipped before the meal to stimulate the appetite.

Others are digestivos designed to settle the stomach. Many accomplish both tasks, whether sipped neat or on the rocks, in a cocktail or with a splash of soda.

By way of explanation for his bitter orange ardour, Martini references his Italian roots and his family’s fondness for the Spritz cocktail, which was introduced by Aperol, another amaro, in the 1950s.

Aperol has been around since 1919 when it was launched by the Barbieri brothers at the Padua International Fair. Interestingly, I met Martini and Myers at Vancouver’s annual BC Distilled festival where the pair debuted their amaro. Although they’re not fratelli, Martini and Myers describe their venture as “the combined curiosity of two friends whose lives have been enchanted and shaped by the West Coast…” Perhaps their amaro will endure for a century too.

My own enchantment with amari was similarly sparked by a Spritz I sipped in Verona, the locale of another love and war story, starring Romeo and Juliet.

On the bitter spectrum, Aperol is sweeter and less bitter compared to Campari. The Woods Spirit Co.’s amaro starts off sweet and citrusy and has a pleasingly bitter finish, close to Campari in my mind. “We worked really hard to balance it,” says Martini. In keeping with tradition he stays mum on the “unconventional sweetener” they use. The bitter ingredients, however, include bitter orange, gentian and wormwood. The West Coast homage comes

from the addition of grand fir needles, which impart nuances of grapefruit.

“We also use a lot of rhubarb,” says Martini, which is a go-to bitter ingredient in most amari, including Aperol and Campari. The latter also includes ginseng and chinotto, an Italian bitter orange. For my taste, though, Amaro Nonino Quintessentia hits the bittersweet spot compared to Aperol (too sweet) and Campari (too bitter).

These orange-forward amari are typically lighter in colour and alcohol, with a few exceptions. Recently, I’ve started exploring their darker, higher-proof side, starting with Amaro Ramazzotti, which claims to be Italy’s first bitter liqueur. Introduced in 1815, it’s made with a secret blend of 33 herbs, roots and spices. A handful of ingredients include star anise, orange, cardamom, cloves, galangal and myrrh. It’s thick and reminds me of another herbal liqueur: Jägermeister. I like the level of bitters, but I prefer the more chocolate-y and citrusy taste of Averna Amaro (introduced in 1868), though the bitters are definitely on the tame side.

Then there’s the legendary Fernet-Branca, which is toe-curlingly bitter, just the way San Franciscans and Argentinians like it. It’s often reported that their lust for the liqueur drinks up a staggering portion of Fernet-Branca’s market share. Fernet-Branca has been made since 1845 following a formula of 27 herbs (the ususal suspects, plus chamomile, aloe and saffron). Its minty aroma is alluring but it takes just a single sip to be hit with its boozy bitterness, finished with a rush of mint. I’m smitten already.

You never know what you’ll fall in love with, but exploring amari might be the start of a beautiful relationship. As for Martini and Myers, one thing is for sure. They’ll never be short of their beloved amaro.

Less bitter

Aperol 11% ABV Aperol Spritz 3 parts Prosecco 2 parts Aperol 1 part soda Pour all ingredients into a wine glass.

Garnish with an orange slice.

More bitter

Nonino Quintessentia 35% ABV Aperol Spritz 1 oz Nonino Quintessentia Amaro 1 oz Aperol 1 oz Bourbon 1 oz Lemon juice Shake together with ice. Strain and serve.

Campari 25% ABV Negroni Stir together equal parts of each: Campari, gin, sweet Vermouth.

Serve over ice. Garnish with an orange slice.

Brown + boozy

Light(er) + citrusy

know your bitter booze Less bitter

More bitter

Ramazzotti 30% ABV

Averna 29% ABV

Fernet-Branca 39% ABV

Ragtime

Black Manhattan

Hanky Panky

1 oz Rye whiskey 1 oz Amaro Ramazzotti 1 oz Aperol 2 dashes Peychaud’s bitters Absinthe mist

2 oz Bourbon 1 oz Averna Amaro 1 dash Angostura bitters

1.75 oz Gin 0.75 oz Sweet Vermouth 0.25 oz Fernet-Branca

Stir. Strain. Garnish with an orange twist.

Stir with ice; strain into a chilled cocktail glass.

Garnish with a cherry.

Stir with ice; strain into a chilled cocktail glass. Garnish with an orange twist.

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travel the world

n o rd i c

coo l

travel the world

D isc Su n o v e r t h e n A l p m ør e s N or an g an d sdal en

From dramatic fjords to haute hideaways, Norway continues to have its moment.

And another. Hello, Valhalla… story + photography by barb sligl

[stay]

Deep in fjord country on the shores of Norangsfjord, off Hjørundfjord, where just beyond these red sheds is the historic Hotel Union Øye.

Summer 2016 Just For Canadian doctors

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travel the world

The view of the Bøvra River and Jotunheimen mountains from Røisheim Hotel. below left Classic red house in Losbydalen near Losby Gods. below right Fiskesuppe. bottom The Art Nouveau city of Ålesund from the viewpoint on Mount Aksla.

[stay]

Losby Gods losbygods.no

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Just For Canadian doctors Summer 2016

O

n the edge of a fjord, surrounded by mountains, with nothing but the whisper of trees in the wind (or is that the murmur of trolls?), you can soak in a claw-foot tub made especially for Kaiser Wilhelm. If the Kaiser’s room is not to your liking, there’s Sir Arthur Conan Doyle’s, Princess Victoria’s, Edvard Grieg’s, Henrik Ibsen’s or Roald Amundsen’s.

The appropriate choice would be Amundsen’s, as this is in the wild beauty of Norway, in the tiny town (40 inhabitants!) of Øye on Norangsfjorden, an arm of the outof-this-world Hjørundfjord (Geirangerfjord gets a lot of love as a UNESCO World Heritage Site, but arriving here by boat blows it away). The legendary Norwegian explorer, who made it to the South Pole first in 1911, was a guest here in Hotel Union Øye’s heyday.

I stay in The Blue Room, Det Blå Rommet, the only one of 27 rooms at this 1891 hotel that’s not named for a famous guest. Instead, this melancholically named suite recalls the tragic love story of Linda, who killed herself after her lover never returned to this isolated spot on the edge of a fjord. And she’s still here, waiting. The hotel helpfully provides a silver bowl of garlic upon checking in. If you want to visit with Linda, leave the bowl outside your door; if not, place it on the bedside table (I’ll only say that while I did hear some thumps in the night, they came from the modern-day amorous couple above me).

Old and new, traditional and modern, wild and civilized, pragmatic and idealistic, simple and sophisticated…these are all part of the Nordic charm. For Norway has it all. Despite being a relatively new country, having only gained independence from its somewhat overbearing Scandinavian neighbours in 1905, there’s a deep sense of history and culture that includes a whole-hearted affection for trolls and its Viking past (this is the land of Valkyries and gods of Norse mythology) and is celebrated with unabashed civic pride on Syttende Mai, Norway’s version of a national day. But this liberal country is also cutting-edge cool, where architecture firm Snøhetta’s Oslo National Opera and Ballet building is a gleaming beacon of Norway’s progress (Snøhetta, also the name of a mountain peak in Norway, is behind many world-renowned award-winning designs, including the recently reopened SFMOMA in San Francisco), as are the avantgarde design statements of rest stops and viewing spots along 18 National Norwegian

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The elaborately carved 12th-century wooden stave church at Lom, near Røisheim Hotel.

Women in traditional dress on Syttende Mai in Ålesund.

Nordic cool outside the Oslo National Opera and Ballet.

The view from the Markjordbaer or “Strawberry” room at Storfjord, overlooking the fjord and village of Glomset.

[stay]

Storfjord Hotel storfjordhotel.com

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[stay]

Røisheim Hotel roisheim.no

[stay]

Hotel Brosundet brosundet.no

The Hotel Brosundet hugs the water in Ålesund. above left Key to one of the rooms at Røisheim Hotel, a converted stable. above right The shrimp salad at Maki, one of Norway’s finest seafood restaurants. below left Kaiser Wilhelm’s monogrammed tub at Hotel Union Øye. below right The delightful brunost or brown cheese.

Tourist Routes (one of which Snøhetta also designed).

Yes, Norway is having its moment, and another, and another…

Upon waking up from a glorious sleep on the edge of Norangsfjorden in The Blue Room (thank you, Linda), I walk through the village of Øye to wander up a hiking path through meadows and just-tilled fields to a glade with perfectly bulbous mossy rocks (trolls’ homes, I’m sure) for a bird’seye view of the hotel far below—a perfect dollhouse dwarfed by the Sunnmørsalpene or Sunnmøre Alps, the fjord on one side and Norangsdalen, a valley known as “The Queen’s Route,” on the other.

I may not be a queen, Kaiser or epic adventurer but I feel like one in this isolated bit of paradise, and in that spirit I follow the path laid by erstwhile explorers at the turn of the 18th century. On this winding valley road from Hotel Union Øye I spot sod-covered houses, almost completely camouflaged, where people (and trolls!) have lived for centuries. It’s easy to picture Vikings here in what’s one of the narrowest valleys in Norway—misty, still flocked with snow, barren yet beautiful.

The twisting scenic drive through Norangsdalen eventually leads back to the coast and Ålesund, an Art Nouveau city that was completely rebuilt after it was destroyed by fire in 1904. Candy-coloured facades are like a stage set. I walk the streets craning my neck to take it all in, and then trek up a zig-zag of 418 steps (at the start of which stands a statue of Rollo the Viking, founder of Normandy and forefather of William the Conqueror) to gaze down upon the ridiculously pretty town, its delicate buildings set right at the water’s edge and surrounded on all sides by the sea. Fjords meet mountains meet ocean on Ålesund’s islands, all connected by masterful Norwegian engineering via sub-sea tunnels and spread before me from the perch of Mount Aksla.

Back at sealevel, I hole up in one of those Art Nouveau buildings that seem to float atop the water. Hotel Brosundet was once a storehouse for klippfisk or dried and salted cod (and still a major export of Norway). The boutique hotel (with 47 unique rooms, including a lighthouse), reimagined and designed by Snøhetta, melds history with some serious hip factor. And it’s home to one of Norway’s finest seafood restaurants, Maki, with a signature eightcourse tasting menu based on the catch of the day. The fiskesuppe or fish soup is divine (the gods share their spoils here), as is the shrimp salad.

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[stay]

Hotel Union Øye unionoye.no

Norske vafler at Storfjord Hotel.

Outside the Hotel Union Øye.

above

A charming Norwegian man in Ålesund, dressed for Syttende Mai. above The fjord route to Storfjord Hotel.

travel the world if you go From Ålesund, it’s a spectacular hourlong boat ride along yet another fjord (or a half-hour drive by car, if you must) to Storfjord Hotel, self-described as “a slow-life hideaway.” Indeed. The Norwegians know how to be super-efficient (I’m thinking of those sub-sea tunnels and proposed Stad Ship Tunnel…yes, a 1.7km-long, 36m-wide, 45m-high tunnel through solid rock for ships) yet luxurious in their enjoyment of life.

At the lavish boutique Storfjord Hotel, on a secluded hillside overlooking the fjord and Sunnmøre Alps (just a fjord over from Hjørundfjord and Hotel Union Øye), it’s all about lapping up the Norwegian lifestyle in the form of local food and thoughtful design. Rough-hewn log buildings, adorned with a living roof of lovely tufts of grass, seem as if they’ve been here since the Viking days, yet the hotel is just a decade old (and has become one of the country’s top-rated overnight stays). Sheep- and reindeer-skin throws, folktale books, handcrafted rugs and, of course, a welcoming troll at the reception desk exude Scandi chic. Everything honours local ingredients—whether in design or dining—and combines Norwegian tradition with a modern sensibility. Like Norske vafler.

take to the water When and west Norway I sample a exploring fjord country on Norway’s version of these that dates back western coast, do it by boat. Ålesund-based to 1858 (some Norwegian 62ºNORD specializes in “bespoke travel in fjord waffles with tar-painted Norway,” from sea safaris in a high-speed RIB boat outbuildings local dande(must-see: eagles and puffins at the Runde bird are from the lion syrup, sanctuary) to transport to-and-from fjord-hugging berries and 1700s) and also properties like Storfjord Hotel and Hotel Brosundet.

62.no/en stay in a historic property hosted Grieg homemade Make like a king or queen and stay in one of the ice cream. I and Ibsen. spectacularly set and stylish boutique hotels in I stay in Stallen had vafler again the De Historiske collection. dehistoriske.com 3, a former stable (and again) with more Norway’s charms are unlimited… brunost (brown and now one of plan a deeper exploration with the whey cheese that’s 20 quirky yet luxe country’s official travel guide. rooms. Old tacks, sweet yet sharp, visitnorway.com

like a solid and savoury dulce de leche), lingonberry preserves and sour cream, and always in a heart shape (every Norwegian family owns a heart-shaped waffle iron).

Delicious. Charming. Perfectly presented. A manifestation of my fast-growing country crush on a plate.

Inland from fjord country, Norway’s mountains continue, rising to the Jotunheimen National Park, where the country’s highest mountains are concentrated. Nestled here is another historic hotel, Røisheim, once a way station between east

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bridles, stirrups and other equine accessories decorate my room, as well as a Viking-sized wooden bathtub. It’s where I happily soak after a hike up the slope behind the property to another fairytale view, this time of the Bøvra River and Jotunheimen.

Farther south, just outside the capital of Oslo, things get more pastoral at yet another historic property that’s become a modern getaway. Originally the hunting lodge of one of Norway’s most prestigious families, Losby Gods is an 1850s-era estate turned into a resort of sorts, with two golf courses, a driving range, tennis courts and its own brand of aquavit and beer. And while the “gods” in its name actually means “mansion,” the setting feels Valhalla-like and has feted the likes of Norway’s first King Haakon VII and more recently Kofi Annan and Bono, who both walked these grounds when the Oslo Forum peace conference was held here.

I hop on one of the hotel’s bikes and roll through a tiny bit of the thousandsomething acres of forest and lakes of Losbydalen, past locals walking dogs, adventurers pulling kayaks, mountainbikers kicking up dust. I stop at one of the iconic red cabins that seem to dot Norway’s countryside. The deep red was once a hallmark of a humble working-class house, but the bright hue now seems as fresh as everything else in Norway.

Back at Losby Gods I sip a Fjellbekk or “mountain stream,” a classic Norwegian cocktail (made with aquavit, naturally) that’s rather fitting as I contemplate the wild beauty around me. With more than 25,000km of jagged coastline along fjords, up mountains, down valleys, across rivers and ancient trade routes—the vast playground of queens, kings, explorers, starcrossed lovers, Vikings, gods and trolls— Norway has every reason to be showy.

It’s a stunner…and yet no drama queen. It’s Nordic cool.

seattle / queenstown / copenhagen / doha / ottawa … | c a l e n d a r

cMe

A n intern ation a l guide to continuing medica l Education

summe r 2016 + beyond

SEATTLE

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1

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The “Emerald City” of seattle is laidback west coast but also cutting-edge, the birthplace of grunge music and also some über-modern architecture (CME events in Seattle + beyond are highlighted in blue.)

hotel and restaurant photos, courtesy of provenance hotels and The Miller’s guild; other photos: b. Sligl (3)

S

eattle is often referred to as Emerald City. And while that’s a reference to the fantastical place in The Wizard of Oz, it’s also a moniker for the lush and green coastal wonderland of Seattle on Puget Sound in the Pacific Northwest. Washington State’s largest city is known for many “wonderous” things; it’s ground zero of grunge music and tech-forward companies like Microsoft, Amazon and Boeing. There’s a new-world gleam here as well as a rebellious spirit. This is the birthplace of the Starbucks coffee empire (its Pike Place roast is now ubiquitous but is named for Starbucks’ very first location at Seattle’s public market). And yet the city’s caffeinated can-do spirit is tempered with an easy-going PNW vibe that puts the outdoors (Seattle comes by its Emerald City nickname because of thousands of acres of parkland) and west-coast lifestyle first and foremost.

While the Space Needle (a legacy of the 1962 World’s Fair) may still be the city’s most iconic landmark, there’s far more futuristic architecture to behold in Seattle. Within the Needle’s shadow is the sinuous EMP Museum 1 . It stands for Experience Music Project and as such its mission statement states that it’s a “leading-

edge nonprofit museum, dedicated to the ideas and risk-taking that fuel contemporary popular culture.” And gazing up at its gleaming, undulating Frank Gehry design (made of 21,000 aluminum stainless steel shingles and 280 steel ribs), one can envision the cross-sections of curvilinear guitars that the architect says inspired him and served as building blocks. And inside “boldly go where no one has gone before” via the Star Trek: Exploring New Worlds exhibition (opening May 21). {empmuseum.org} Also currently showing at the EMP: Nirvana: Taking Punk to the Masses. The band most associated with grunge music also embodies Seattle spirit. Local label Sub Pop Records signed the band in 1989, over 25 years ago, and to relive some of that era stay at the Hotel Max, the art- and music-filled boutique bolthole that recently revealed an exterior mural (proudly proclaiming that “Seattle doesn’t settle” in six-foot tall letters 2 ) and a redesigned lobby that shows off vibrant art (including an original Warhol and a bass guitar signed

by Krist Novoselic of Nirvana), along with a retail shop collaboration with Sub Pop. Also on offer: free samples of local Caffe Vita brew in the morning and craft beer in the

afternoon…and there’s a Sub Pop floor in which to hole up and listen to tunes 3 . {hotelmaxseattle.com} Attached to the Hotel Max lobby is The Miller’s Guild, where a custom-made nine-foot-long Infierno wood-fired grill is a fiery centrepiece. The name is inspired by the building’s past as the 1925 Vance Lumber Company Hotel, where workers rested between harvesting and milling trees in the surrounding forests. Now it’s all about nose-to-tail cuisine and other fire-roasted PNW fare, as well as cask-aged craft cocktails 4 . {millersguild.com} More of Seattle’s creative spirit and innovative pioneering is found at the central branch of the Seattle Public Library. The multi-faceted structure, as if a bright gem nestled in the downtown core, is the creation of another internationally renowned architect, Rem Koolhaas and former Seattleite Joshua Ramus 5 . Take a free guided tour of its award-winning architecture, including a maple floor that’s made of 556 lines of raised text in 11 languages 6 . {spl.org} — Barb Sligl For more visitor info on Seattle go to visitseattle.org.

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CAAM 13th Annual Conference

Friday, September 23 to Sunday, September 25, 2016

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CAAM Fundamentals of Aesthetic Laser Therapy Course (sponsored by AMT™ Academy) Saturday, September 24 to Sunday, September 25, 2016

The Westin Prince Hotel - Toronto, Ontario

The Canadian Association of Aesthetic Medicine will host two programs this year, both held at the Westin Prince Hotel in Toronto, Ontario. We invite you to join us and attend one of these exciting programs!

CAAM Office c/o CongressWorld T: 604.988.0450 info@caam.ca www.caam.ca

Please visit our website for information on the CAAM 13th Annual Conference…

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-Course Information & Description http://www.caam.ca and select AMT™ Laser

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1st Pan American Parkinson’s Disease & Movement Disorders Congress

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40th Annual Florida Suncoast Pediatric Conference

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Symposia At Sea: Comprehensive Practical Approach To Breast Imaging

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Postmortem CT Interpretation

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travel at home

The first sign of the approach to Manitoulin island from points east is the Strawberry Island lighthouse.

Sail away to god’s

island On a “Summer Breeze,” past Group of Seven scenery, to the most beautiful anchorage in the world…

s A n c h or ! a w e i gh

story by Mark Stevens | photography by Sharon matthews-stevens

travel at home

Ed North (left) and the author (right) stand lookout to navigate the tricky Channel. left Bridal Veil Falls on Manitoulin Island, a short hike from the popular “overnight” dock at Kagawong.

The most beautiful anchorage in the world, South Benjamin Island. right A bit of company shares the waters off Croker Island. opposite “Summer Breeze” is just one of more than a dozen boats in the fleet maintained by Canadian Yacht Charters.

30

Just For Canadian doctors Summer 2016

travel at home

W

e’re skimming the waters of Frazer Bay in Ontario’s Georgian Bay in a forty-nine-foot sailboat named “Summer Breeze.”

The quartzite LaCloche Mountains, their rugged slopes white as a February snowfall in the afternoon sun, reach skyward off our starboard quarter. Far astern we can see Killarney Provincial Park and Baie Fine. Royal blue decorates the bay, mirroring the sky but for whitecaps scattered like lace collars across its wind-riffled surface.

Those landmarks inspired numerous Group of Seven paintings. No surprise there: the views embracing us show like landscapes painted by masters.

“Summer Breeze” groans in twenty knots of wind, leaning precipitously, a position that would be frightening but for the fact that this is how she sails—and that all aboard know what we are doing.

We’ve chartered this boat from Canadian Yacht Charters out of Manitoulin Island’s Gore Bay. If you know how to sail, they’ll rent you the boat. If you don’t, you can book a skipper.

We’re navigating the North Channel, guarded to the south by Manitoulin Island and by the Canadian Shield to the north, an east-west passage marked by roughly 300 islands, most of which are unmarred by human occupation.

It’s one of only two Canadian destinations cited in a book called “Fifty Places to Sail Before You Die,” one of the world’s best freshwater cruising grounds.

My wife and I first sailed here in 1999.

It’s the first voyage for our friends, Kim and Ed North. Serious sailors, they’re here to help us work the boat—and to sail paradise itself.

And now I yell over the howling winds.

“Manitoulin, dead ahead.”

I point past a white lighthouse with a fire-engine-red roof toward a blue-gray expanse rising up from Lake Huron like a great leviathan.

“We’re sailing to God’s Island.”

First Manitoulin waypoint is Wikwemikong, one of the few First Nations territories local Ojibwa never ceded to the government. Come here in August

to participate in one of Canada’s biggest powwows and take in some First Nations theatre. Hike to picturesque waterfalls, climb to the crest of Niagara escarpment ridges, rent a bicycle, recline on a beach you’ll share with no one, and take in some history.

Explore a fascinating—and sacred— island.

Legend has it that Manitou—the Anishnabe God—saved the bluest waters, the brightest stars, the most scintillating quartzite to make his own retreat—placing it, the world’s largest freshwater island, right here.

Off the port bow.

Tonight we’d make landfall at Little Current, one of the island’s few settlements, securing “Summer Breeze” to a dock, dining ashore on local whitefish.

“And tomorrow,” says Ken Blodgett, the fifth member of our ship manifest,

“We swung at anchor in what felt like the sanctuary of an emerald cathedral” who’s taken over the helm, wrestling the boat through waves that shatter into scintillating spray as we chase the sun west, “we’re taking you to the most beautiful anchorage in the world.”

Blodgett owns Canadian Yacht Charters and has become a friend over the years.

Given that it’s late summer, so things

are slower back in Gore Bay, and given that Blodgett has promised to show us “secret spots you can only imagine,” we enthusiastically add him to the crew list.

Tomorrow he’d share one of those secret spots.

Yesterday he shared another one: the Pool in Baie Fine, where we swung at anchor in what felt like the sanctuary of an emerald cathedral.

Early this morning we dinghied ashore from that anchorage, tying to a rudimentary dock and climbing a logging trail to a hilltop lake nestled in a granite cradle, surrounded by gnarled windcrippled pine, boasting waters so clear you could see ten metres down, painted—like its name suggested—topaz.

“Just wait until tomorrow,” I tell Ed and Kim. “We’ll take you to a really pretty spot.”

A spot called South Benjamin Island, a spot I consider the most beautiful anchorage in the world, a spot we would achieve on our last full day on the water, after a lunch stop at Croker Island, hot dogs

Summer 2016 Just For Canadian doctors

31

travel at home

on the barbecue in a delightful granite bowl decorated by pine, by juniper, by fecund blueberry bushes.

Lunch done, we raise anchor and power west, past Sows and Pigs, a collection of surreal rock outcroppings rearing up from the water like breaching whales.

Kim notices a black irregularity in the water’s surface just off the port stern. “What is that?” she asks.

Ken slows the engine, we make a lazy circle.

We squint at this ‘bump’ then someone realizes that it’s moving, a small wake The Pool in Baie Fine, another fanning out from it. It is a black bear. anchorage regulars consider one She looks at us; she swims away. of the world’s most beautiful.

We give her space, but follow her until she reaches a headland off Croker.

She clamours ashore, up onto the rock, turns to face us contemptuously, shakes vigorously, then disappears into the forest.

That evening, as the sun falls in the west, as we swing gently off a curvaceous slab of pink granite, blushing in the sunset, I reflect on the spectacle of the she-bear, nature setting out as if to convince us we were sailing paradise itself, on other highlights, on other visits.

I’m sitting on the shore, gazing at “Summer Breeze”, inhaling the scent of pine, listening to the water lapping the rock shore in liquid melody, the echoing call of a loon.

I remember our first day out of Gore Bay, navigating shoals in Clapperton Channel, skies heavy, vista a minimalist line drawing: sky, rock, water in pewter and purple hues.

I remember the dawn light at Killarney; North Channel scenery like this— prime Canadian Shield—inspired the sun spotlighting a fishing boat, painting the art of members of the Group of Seven. forest rose then gold.

I remember a dock at Kagawong on Manitoulin itself, a circa-1920s general store across from a church whose pulpit was built from the prow of a boat shipwrecked just offshore.

Now Ed climbs the slope; he sits beside me. I point south to the far reaches of the channel, toward the world’s SAIL AWAY To book your sailing biggest freshwater adventure—either with a skipper or island that even on your own—and to check the fleet of now disappears available boats, log on to cycnorth.com in the dusk. or call 1-800-565-0022 to book. PLAN NOW For more info on God’s Island “Manitoulin,” I say, and other shore-based options, “Home of the Great check out manitoulinSpirit.” And then tourism.com.

I pause reflectively.

“God’s Island.”

if you go

32

Just For Canadian doctors

Checking out the directions to sail to God’s Island. below Killarney Mountain Lodge— dock here for the night and sample the attractions of this friendly Ontario lodge.

travel at home The Inukshuk, symbol of Northern hospitality, graces the shores of North Channel from a stone beach on Manitoulin Island. right Kim North, a member of the crew, scans the horizon en route to God’s Island.

One of several charming and rustic villages en route, Killarney offers a chance to stock up on groceries, souvenirs or special delicacies.

Another must-do anchorage, Croker Island offers several spots for boaters to drop hook for the night.

Gore Bay, home of the Canadian Yacht Charters base, opens up to the channel from the north coast of God’s Island. left From a distance it looks like splashes of paint, up close you can see that this extra bit of colour comes from lichen on the rocks.

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Just For Canadian doctors Summer 2016 Work & Play in Georgian Bay-AD 2016 May-16-16 11:11:05 AM

2016-05-24 4:14 PM

office space / positions / locums / + more

Richmond, BC — Family Physician Recruitment January 2017 Our colleague will be leaving her busy practice which is a part of our group family practice in the south-east of Richmond BC (juncture of Richmond, Ladner and Tsawwassen), with easy highway access. We require a family physician who must be comfortable with good primary care, women’s health and EMR skills. Fast paced, friendly environment, supportive staff, 3 -5 working days, competitive split.

Seeking a long term associate to take over a built up longitudinal care practice with some walk in component. www.mydoctor.ca/drsinghal CPSBC Provisional Licensure Applicants from IMGs also encouraged to apply. For information please contact office number: (604)-448-9595 or email: msinghalmd@gmail.com.

Richmond, BC — ­ Cosmetic/Aesthetic Dermatology Wishing Lasers We are interested in sublease of Dermatology Lasers as demand for such services grow.

Our practice is located in the south-east of Richmond BC (juncture of Richmond, Ladner and Tsawwassen) with easy highway access. We are seeking to sublease with potential to buy or lease takeover of Dermatology Lasers for Cosmetic/ Aesthetic Dermatology. We recognize there are quite a few physicians who have leased or purchased lasers which are being underutilized and would wish a symbiotic agreement in using the Lasers for private patients. www.mydoctor.ca/ drsinghal For enquiries please contact office number: (604)-448-9595 or email: msinghalmd@gmail.com.

d o c t o r o n a s o a p b o x d r . C h r i s P e n g i l ly Dr. Chris Pengilly is Just For Canadian Doctors’ current affairs columnist. Please send your comments to him via his website at drpeng.ca.

keeping to time

Patients note punctuality…and so should the family physician

A

s I look back over my 35 years in family practice I remember many challenges, but one constant is trying to keep to time. This is in spite of my default office visit time being 15 minutes.

Patients note punctuality. I was checking the RateMDs site at random and noticed that physicians who score 5 out of 5 for helpfulness and knowledge will quite often score poorly with punctuality. Being kept waiting may just be the precipitant for a complaint to the provincial regulatory college. A reasonable rule-of-thumb is the 15/80 target—i.e. wait time should be 15 minutes or less 80% or more of the time.

There is no single solution to this problem, but I will outline some of my ideas, and I would welcome suggestions from readers.

First of all, it is important to be aware of time. Each examining room should have a clock that can be surreptitiously observed by the physician—i.e. it should be sited behind the patient.

Avoid starting the office late.

Occasionally this is unavoidable, but is now easier for most urban physicians who no longer make hospital rounds prior to going to the office. It is a good policy to arrive early to clear tasks before they cut into patient contact time. This time can be productively spent reviewing that day’s booked patients’ charts to ensure that the relevant documents and results are ready. If

they are not then the MOAs or medical office assistants can chase them up well ahead of the visit. If there is no hope of obtaining the information prior to the visit, the appointment should be postponed, saving the patient a wasted trip (which the patient will appreciate—good PR) while opening up space for another appointment—often welcome news to the office staff.

Probably one of the most pernicious causes of running behind schedule results from accommodating urgent same-day appointments. This can be solved to a large extent by “open access” scheduling. This is where appointments are reserved and will be filled only on the day of the office. Even if the default booking time is 15 minutes, these open-access appointments can be scheduled for 10. There is no hard-and-fast rule for how these should be scheduled. I have found that a half-hour in the middle of the morning, an hour prior to the lunch break and another hour at the end of the day works well. This can accommodate 15 patients. The concern expressed by many physicians is that they do not want to be sitting in the office doing nothing. In practice this does not happen. It is my experience now for many years that all these same-day appointments are taken within an hour of the office opening. On the rare occasion when they are not all taken then it can be an opportunity for paperwork or even to

go home early.

This concept will take training of the office staff Dr. Pengilly and the physician. shares 35 years’ It must be emphasized at worth of tips the time of the booking in the second that these appointments edition of his are for urgent simple book. problems, and that message further reinforced by the physician. Most, but not all, patients will comply since they will be pleased to be able to see their own physician in a reasonable time. Should an encounter involve a more complex situation, investigations can be initiated, palliation prescribed and a subsequent scheduled appointment made.

Several things can be done to make the encounter as time efficient as possible. Look for any repetitive actions that rob you of useful time from office visits. One example is not having a printer in the room when EMR prescriptions are used. It is not good use of physician time to leave the room to pick up the prescription from a central printer. A label printer in each room is also an inexpensive time saver.

This topic is just part of the latest chapter in my manual The Successful and Auditproof Medical Office—Second Edition, subtitled Going Electronic and Paperless and now available (see drpeng.ca).

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t h e w e a lt h y d o c t o r m a n f r e d p u r t z k i Manfred Purtzki is the principal of Purtzki & Associates Chartered Accountants. You can reach him at manfred@purtzki.com.

how to create wealth

Wealth creation tips for new doctors…and good reminders for well-established MDs

Put time aside to educate yourself on financial matters

2 Start early Follow the timeless financial advice in the 1926 book: The Richest Man in Babylon. Save 10% of your income and start early. If your annual revenue is $300,000, then start investing $30,000 per year. Your savings will grow in 30 years to $2 million, assuming a 5% rate of return. To ensure you stay the course, consider arranging for an automatic money transfer each month from your practice bank account to your investment account.

This 1926 classic still has some of the best financial advice: Save 10% and start early.

skills alone does not guarantee financial success. Doctors with an entrepreneurial mind have a vision of how to reach both professional and financial success.

To start thinking like an entrepreneur, it is critical to put your vision and goals on paper. A Yale University study found that less than 5% of one year’s graduating class had written down their career goals. When the graduates were surveyed 30 years later, the researchers found that those who had

36

income, you have $86 out of $100 of income available for investment. Also consider proactive tax strategies to lower your personal taxes. Income splitting of practice income with family members in a lower tax bracket creates huge tax savings and is the most important tax shelter for high-income Canadians. Many doctors have found that the tax savings alone can create a sizable retirement nest egg without the need to work any harder.

I recommend putting time aside to educate yourself on financial matters.

Make your financial planning an enjoyable journey with the goal of building wealth for retirement, free of any money worries.

3 Live within your means You do not need to adopt the extreme frugal lifestyle of Ingvar Kamprad. With an estimated net worth of $42 billion, the 95-year-old founder of IKEA lives like a pauper, flying economy and getting cheap haircuts in developing countries. Many of the highest income earners in the medical profession live from pay-cheque to paycheque, because their personal and living expenses are out of control.

4 Pay yourself, not the taxman You will never be able to create wealth when you pay over 40% of your income in taxes. Make tax planning a priority! Consider incorporating your practice as soon as feasible. If the corporation only pays a low corporate tax of, say, 14% of your practice

Just For Canadian doctors Summer 2016

solution from Spring 2016 contest

1 Think like an entrepreneur As a doctor, you are equipped with the skills needed to give your patients the best treatment. However, the application of those

taken the time to write down their goals owned 90% of the total wealth of the graduating class.

Entrepreneurs also realize that to achieve exceptional investment returns requires taking risks. It is not surprising that most doctors with a high net worth built much of that wealth by investing in real estate and equities, both considered more risky than most investment vehicles. And when entrepreneurs realize that they have made a bad investment decision, they face the facts, cut their losses and move on.

solution from page 37

Y

ou’ve finished your residency and you’re ready to settle into your practice life. And your current financial picture looks pretty bleak, with a student loan of $250,000 and no assets. You wonder if you will ever generate enough income to pay off your student loan quickly, purchase a home, finance the children’s education and ultimately generate enough retirement income at age 60.

How do you create sufficient wealth so that you will never have to worry about your finances?

sudoku 2 harder solution 1 9 4 7 6 3 2 5 8 8 2 7 5 9 1 6 3 4 5 3 6 2 4 8 7 1 9 2 6 3 9 1 4 5 8 7 7 8 9 3 2 5 1 4 6 4 1 5 6 8 7 9 2 3 3 5 8 1 7 6 4 9 2 6 4 2 8 5 9 3 7 1 9 7 1 4 3 2 8 6 5

Puzzle by websudoku.com

sudoku 1 easier solution 5 2 6 7 9 4 3 1 8 9 3 1 8 5 6 2 4 7 8 4 7 1 2 3 5 6 9 6 5 3 2 1 7 9 8 4 4 1 8 6 3 9 7 2 5 2 7 9 4 8 5 1 3 6 3 8 5 9 6 2 4 7 1 1 9 4 3 7 8 6 5 2 7 6 2 5 4 1 8 9 3

Puzzle by websudoku.com

diversion

sudoku Solve puzzle #2 for a chance to win a $50 VISA gift card!

Each sudoku puzzle has a unique solution that can be reached logically without guessing. Fill in the grid so that every row, column and 3x3 square contains the digits 1 through 9.

GOOD LUCK!

sudoku 1 easier solution on page 36

5

sudoku 2 harder solution in next issue

$50 Visa Gift Card winner: Dr. Donald Whelan of Ancaster, ON

2

6

4 3 3 6 2 4 8 3 1 7 9 2 4 7 8 3 5 9 4 2 9 1 9 4 3 5 8 2 5

7 5 1 3

Puzzle by websudoku.com

7 3 8 9 4

5 3 1 2

5 3 2 6 6 9 5

3 4 7 2 1 4 4 1 5 9 6 4

Puzzle by websudoku.com

Sudoku Contest entry form (solve + send in sudoku!)

Yes, I would like to receive the CME newsletter & updates by e-mail.

NB: Information collected will not be shared with any third party.

Name: __________________________________________________________ Address: ________________________________________________________ City, Province, Postal Code: _________________________________________

E-mail: _________________________________________________________ Tel: ____________________________ Fax: ____________________________ sudoku Contest Rules:

1. Entry form must be accompanied with solved puzzle. Only correctly solved puzzles entered into random draw. 2. Send puzzle + entry form to Just For Canadian Doctors, 200 – 896 Cambie St., Vancouver, BC, V6B 2P6 or fax 604-681-0456. Entries must be received by August 26, 2016. 3. Prize: $50 VISA Gift Card.

4. Contest can be changed and/or cancelled without prior notice. 5. All entries become property of In Print Publications. 6.

Employees of In Print Publications and its affliates are not eligible to participate.

Summer 2016 Just For Canadian doctors

37

s m a l l ta l k

doctors share their picks, plans + pleasures

what’s on your summer reading list? We’ve compiled the favourite books of our past “small talk” subjects to give you a ready-made must-read collection for the cottage dock, backyard hammock or beach this summer. Things are heating up…so find some time to chill with a good book. Here are 11 titles—from Archie comics to Hemingway short stories, and a photo-illustrated book of inspirational writings to a good-old primer on proper grammar.

1

3

2 4

1

Reader + doctor: Dr. Andrew Crosby Lives and practises in: Campbell River, BC Favourite book: Archie Digest

2

Reader + doctor: Dr. Fred Shane Lives and practises in: North Vancouver, BC Favourite book: The Firm by John Grisham

3

Reader + doctor: Dr. Daniel Girgis Lives and practises in: Vancouver, BC, and rural Alberta Favourite book: Dubliners by James Joyce

4

Reader + doctor: Dr. Millan Patel Lives and practises in: Vancouver, BC Favourite book: In Love with the Mystery by Ann Mortifee

5

Reader + doctor: Dr. Alister Frayne Lives and practises in: Fort Langley, BC Favourite book: Herzog by Saul Bellow

6

Reader + doctor: Dr. Jennifer Pearlman Lives and practises in: Toronto, ON Favourite book: The Catcher in the Rye by J. D. Salinger

7

Reader + doctor: Dr. Kellen Silverthorn Lives and practises in: Nelson, BC Favourite book: Capitalism and Freedom by Milton Friedman

8

Reader + doctor: Dr. Ted Jablonski Lives and practises in: Calgary, AB Favourite book: The Book of Answers by Carol Bolt

9

Reader + doctor: Dr. Pippa Moss Lives and practises in: Tatamagouche, NS Favourite book: Stranger in a Strange Land by Robert A. Heinlein

5 7 6

8 10

10

Reader + doctor: Dr. Vincent Lam Lives and practises in: Toronto, ON Favourite book: Nick Adams Stories by Ernest Hemingway

11

Reader + doctor: Dr. Chris Pengilly Lives and practises in: Victoria, BC Favourite book: Eats, Shoots & Leaves by Lynne Truss

9 11 38

Just For Canadian doctors Summer 2016

For more information - Call 800-422-0711 or visit www.ContinuingEducation.NET

Outstanding value for your time and resources Combine live, accredited CME and personal renewal time with family & friends

Featured Destinations March 26, 2017 December 11, 2016 Optimizing Health for You and Your Patients: Infectious Diseases, Regenerative Medicine, and Lifestyle Factors that Enhance Cardiovascular, High Level Wellness Practice Cognitive, Metabolic, and Hormone Function 21 AMA PRA Category 1 Credit(s)™ 21 Contact Hours 21 AMA PRA Category 1 Credit(s)™ 21 Contact Hours 11-Night Southeast Asia 13-Day Australia and New Zealand Auckland to Sydney Singapore to Hong Kong Holland America’s ms Noordam Norwegian Cruise Line’s Norwegian Star

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Please visit our web site for current fees and cancellation policies.

Selected Cruises listed here. See a complete Program Listing at www.ContinuingEducation.NET Accreditation: Continuing Education, Inc is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation: Continuing Education, Inc. designates these live educational activities for a maximum of 14-21 AMA PRA Category 1 credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

March 11, 2017 Primary Care and Geriatrics: Addressing Issues of Aging Patients - 2017 Update 14 AMA PRA Category 1 Credit(s)™ 14 Contact Hours 7-Night Southern Caribbean from San Juan, Puerto Rico Royal Caribbean’s Adventure of the Seas April 9, 2017 Cardiology Issues in Older Adults 20 AMA PRA Category 1 Credit(s)™ 20 Contact Hours 10-Night Panama Canal from Fort Lauderdale, Florida Holland America’s ms Zuiderdam May 19, 2017 Family Medicine 14 AMA PRA Category 1 Credit(s)™ 14 Contact Hours 10-Night Italy and Greek Isles from Rome Celebrity Cruises Celebrity Reflection July 10, 2017 Primary Care and Geriatrics: Addressing Issues of Aging Patients - 2017 Update 14 AMA PRA Category 1 Credit(s)™ 14 Contact Hours 11-Night Western Mediterranean from Rome Celebrity Cruises Celebrity Reflection September 18, 2017 Primary Care and Women’s Health: Key Topics and Core Strategies 14 AMA PRA Category 1 Credit(s)™ 14 Contact Hours 10-Night French Riviera, Barcelona, Spain to Venice, Italy Celebrity Cruises’ Celebrity Constellation

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product Description

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Beutlich product Number

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product Description

Beutlich product Number

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